In Coxsackie, N.Y., Tuesday, several
AIDS activists marched
to the gates of Coxsackie Correctional Facility and dropped 2,000
condoms at the feet of corrections officers. New York state prohibits
inmates
from having condoms, and officials say sex between inmates is
illegal.
But members of ACT UP-NY claim state officials are ignoring the
reality
of inmates having sex, and some prisoners are becoming infected
with HIV
behind bars. "The New York state prison system is a factory
for thousands of new HIV infections each year,"said
Ken Bing,
an ACT UP/NY member. "When prisoners are released, those
new HIV infections become a public health crisis for their
home communities. Prisons are pouring a huge HIV burden out
into New York state, which has a horrific human cost as well
as a financial cost to the state,"Bing
said.

Condoms in prisons
The AIDS Coalition to Unleash Power is asking prisons to distribute
condoms to inmates. Why is prevention in prisons important? After
all, many people may find it hard to feel sympathy for convicted
criminals. But research has shown that inmates health will inevitably
have an impact on general public.

Inmates are not allowed to have condoms
because they are considered contraband. That is a problem when
it comes to the spread of HIV.

Stevens said, "State Commissioner Gord,
he's the State Commissioner of DOCS, he says that condoms are
illegal yet we have a letter from him saying prevention in his
prisons is important. Yet it flies in the face of all logic that
he's saying prevention is important and the condom is a very simple
tool to provide that."

Dave Howard knows a lot about the prison
health care system. After all he spent 16 years of his life there.
He is now an educator for the AIDS Council of Northeastern New
York. But during his time in prison, Howard saw more and more
people become infected with HIV, Tuberculosis and Hepatitis C.
He considers himself lucky he does not have any of these diseases
today.

Howard said, "At this point all I can
say that its by God's grace of mercy that I've been spared because
I've done everything everyone else is doing."

The rate of HIV in prison is five times
higher than outside those walls. Non-profit groups like ACT UP
that advocate better health care in prison, claim the continued
spread of HIV can be slowed down.

Gellman said, "The spread of HIV and
Hepatitis C in New York State prisons could be dealt with and
addressed with the distribution of condoms. Inmates do have sex,
it doesn't matter that it's illegal. It's still a public health
crisis if they have unprotected sex."

Gellman said, "When they return to
their communities which are often poor, working class communities
and they bring an enormous HIV burden with them."

Protected sex is one deterrent, but what
about the spread of disease through intravenous drug use?

Stevens said, "It's a part of harm
reduction and that's a quantum leap and that's something we have
to fight also. But right now a condom is a fight in that direction,
but harm reduction is going to take some time and some education.

Coxsackie, NY -- AIDS activists today attempted
to deliver 2000 condoms to the medical officer at Coxsackie Correctional
Facility. Ten members of ACT UP/NY, the AIDS Coalition to Unleash
Power, brought the condoms to prison gates, but were stopped by
prison guards. Activists deposited the condoms at guard's feet,
chanting "Stop breeding AIDS and HEP C in New York prisons!"
Prison guards ultimately agreed to bring the condoms to the watch
commander, but it remains illegal for prisoners to receive them.

Activists also delivered a letter to Coxsackie
Supt. Filion outlining demands for a coherent HIV prevention program
in NYS prisons.

Inmates in the New York state prison system
are prohibited from obtaining or possessing condoms, except during
conjugal visits. NYS Corrections Commissioner Glenn Goord has
alternately denied that sex occurs among inmates or between inmates
and guards; and claimed that sex between inmates, since it is
illegal, should not be addressed as a health issue by prison staff.
The Department of Correctional Services defines condoms as "contraband."

"Condoms are a fundamental component
of every public health strategy, and every HIV prevention program.
The Department of Health practically begs people to use them,"
said ACT UP member Mel Stevens. "Denying prisoners access
to condoms -- and worse, making it illegal to possess condoms
-- basically guarantees that prisoners will become HIV-infected."

HIV infection rates in New York State prisons
are estimated at 9 -- 10% for male inmates, and 20 -- 25% for
female inmates -- while HIV rates in the general population of
New York State are approximately 2 -3 %.

Although the rate of new infections (seroconversions)
in prison is hard to track, seroconversions among inmates are
clearly and dramatically on the rise. The percentage of inmates
entering the prison system with existing HIV infections has decreased
over the last decade, while the percentage of inmates with HIV
in the prison system has increased markedly, according to Justice
Department and NYS Department of Health researchers -- meaning
that many prisoners are contracting HIV while in custody.

"The New York State prison system
is a factory for thousands of new HIV infections each year,"
said Ken Bing of ACT UP-NY. "When prisoners are released,
those new HIV infections become a public health crisis for their
home communities. Prisons are pouring a huge HIV burden out into
New York State, which has a horrific human cost as well as a financial
cost to the state."

Following their prison visit, activists
proceeded to the Albany office of NY State Health Commissioner
Antonia Novello, demanding that Dr. Novello address the public
health crisis in the New York State Prison system. Vastly substandard
health care also fuels the HIV and Hepatitis C prison epidemics.

"If Commissioner Goord really believes
that his prisons are so magical that inmates don't have sex --
then he's incompetent to deal with the health of inmates in his
custody," said AIDS activist Anna Lynne. "It's time
for the New York State DOH to step in -- there's no room for confusion
about whether there should be condoms and HIV care in prisons.
Dr. Novello must take responsibility for the HIV disaster area
that is the New York State prison system."

Letter To Superintend
Filion that accompanied 1,000 condoms for the General Inmate Population;
letter was also cc: to Glenn Goord, Commissioner of New York Dept.
of Corrections, Lester Wright,
Chief Medical NYDOCS; and personally handed to Antonia Novello,
after a Smallpox Seminar for
DOH employees, where two individuals asked questions on why Smallpox
was more important
than DOH providing AIDS-HIV-HEPC healthcare, education, and prevention
in NYS Prisons.

Superintendent: _________________ 17
December 2002

We are the NO Time To Lose Committeee
of ACT UP. We work on Prison Inmate Healthcare in New York State.
Our visit today is intended as a measure to save lives of New
Yorkers inside prison. We are concerned about the high incidence
cases of HIV/AIDS and HEPC in 70 prisons in the NYSDOCS system.
According to a recent U.S. Department of Justice Report, NYSDOCS
leads the country in AIDS and HEPC rates. As of March 2002, there
were 67,114 inmates under custody. Men constitute 95% of prisoners.
Blacks and Hispanics account for approximately 80% of the inmate
population. 65% of state inmates come from and will return to
New York City. 14% of incoming female prisoners and 5% of incoming
males are infected with HIV; 23% of incoming female inmates and
14% of incoming males have hepatitis C. 75% of inmates are self-reported
substance abusers inside NYSDOCS. The average time served in New
York State correctional facilities is 43 months.

We understand that Coxsackie has a capacity
of 1074 inmates and it houses mostly younger inmates. With approximately
75% of the inmates are under the age of 24 and about 45% are between
16 and 21, and right now that is the leading group of new HIV
infections. Teens represent 2 of every 4 new HIV infections. Coxsackie
has a Regional Medic Unit, run by the Correctional Medical Services
(CMS), a private health care concern. a maximum-security health
facility that served approximately 60 inmates from prisons in
the hub. You also have your own NYSDOCS Medical Service to the
general inmate population. It is reported that you are largely
responsible for the development of the hospice program in 1996.
We know that you showed care in this effort. We understand that
your Medical Director has 22 years on the job and is not board-certified.
He is trained as a general practitioner and has a full-time practice
in Town, along with his Coxsackie duties. He still maintains a
part-time practice on the outside.

Your RMU, SHU and keeplock house between
300 and 400 inmates. Not only are inmates cut off from the outside
world by the Special Housing Unit (SHU) by the thick metal doors
with a small Plexiglas window, but they are also cut off from
education on HIV prevention and medical developments in HIV developments
in research. Many of the prisoners there are teenagers; Three
to four week wait to see the doctor, time during which medical
conditions worsen and patients continue to suffer. Presence of
CO's in the examination rooms, which inmates said makes them feel
self-conscious and hinders open communication. Coxsackie breaches
confidentiality and leaves open the possibility of inaccurate
translation in potentially life-threatening situations with non-bilingual
medical and staff employees. SHU inmates are housed in more restrictive
conditions with a cellmate 24 hours a day. 23-hour lockup, solitary
confinement or double-celling. Prisons within Prison addressing
crime inside prison. The effects of being confined in a prison
cell with another man 24 hours a day have yet to be studied, but
the increases in disruptive behavior and self-harm are not a good
sign. CO's treat many behaviors as a disciplinary problem rather
than a clinical problem. Approximately 80% of state inmates are
self-reported substance abusers. Primarily due to high-risk behavior
prior to incarceration and inadequate health care in the community,
inmates have higher rates of infectious disease and chronic illness
than non-inmates. The U.S. Department of Justice shows that New
York correctional facilities house more HIV-infected inmates than
any correctional system in the country. Recently, DOCS TODAY newsletter
is quoted, "While the Department has witnessed major declines
in HIV infection, Active TB cases across the system in recent
years, staff and inmates must continue to observe proper precautions
to avoid these and other communicable diseases."

Therefore, we are providing you with
1,000 condoms to distribute to the inmate population to protect
themselves and others from HIV transmission.
Condoms are recommended in the science of HIV prevention and care.
We urge you to take the initiative with your institution and stop
the denial about AIDS. Please set up a distribution program that
is non-discrimitory and accessible. In 2000 ­ 2001, the operating
budget for the state prison system was $2.25 billion. We won't
send you a bill for the condoms, if they are distributed to the
inmate population.

We have attached some abstracts from the
recent Conference of the 26th annual meeting of the National Commission
on Correctional Health Care (NCCHC) held October 19-23, 2002 in
Nashville, as reported in HEPP Report by Co-Chief Editor Joseph
Bick. The abstracts back up our demand that a comprehensive plan
to stop HIV, AIDS and HEPC inside and outside NYSDOCS starts with
condom distribution. We appreciate your understanding in recognizing
that prison is punishment and that punishment inside prison is
not the answer.

IDSA abstract #662: This San Francisco
study found a high incidence of proctitis in a cohort of men
who have sex with men. Most cases were due to syphilis, NG, CT,
and /or HSV. As active proctitis is known to increase the risk
for acquisition of HIV, it should be promptly diagnoses and treated.

IDSA abstract #655: This study from Seattle
found that 33% asymptomatic undergraduate men were culture positive
for human papillomavirus (HPC)

NCCHC: Clark, Sylia, and Gaylord presented
a one-year report on the L.A. County jail distribution program.
This intuition which provides condoms and risk reduction education
to self-identified Gay, Bisexual, and Transgendered inmates,
has been accepted by staff and inmates and lead to no disciplinary
issues.

IDSA abstract #7893: The HCV seroprevalence
among incoming inmates to the NYS prison system in 2000-2001
was 23% among women and 13.4% among men. The rate of HIV co-infection
was 5.6% in women and 2.3% in men. Even among non-IDUs the prevalence
of HCV was 14% in women and 9% in men. This data suggest that
inmates should be counseled and screened for HCV even in the
absence of identified high-risk behaviors.

New York Prisons holding the largest
number of prisoners with confirmed AIDSMohawk CF 1408 inmates; 111 with
confirmed AIDS, 7.9 % of all inmates.
Albion CI 1342 inmates; 41 with confirmed AIDS, 3.1% of all inmates.
Attica CF 2211 inmates; 40 with confirmed AIDS, 1.8 % of all
inmates.

State of New York
Department of Correctional Services
The Harriman State Campus
1220 Washington Avenue
Albany, NY 12226-2550
Glenn S. Goord
Commissioner

Letter dated: Dec 2, 2002

Governor Pataki has asked me to respond
to your letter to him regarding HIV/AIDS/HCV in prisons.

Although the numbers and rates of disease
that you cite are long out of date and newer data collected by
the Department of Health show that the number of HIV infected
inmates is now considerably lower, HIV and hepatitis C are indeed
important in the incarcerated population. That is why we have
invested great effort and devoted many resources in dealing with
these diseases. We are working closely with the Department of
Health and its AIDS Institute. We, in collaboration with the Institute,
continue to emphasize prevention.

I am aware that the issue you are most concerned
about is 'latex barriers' and condoms. Since I am well aware of
your position on these and since the decision about their availability
has been made on good penological grounds, there does not seem
to be any need for us to hold a meeting.